In patients with insulin-resistant diabetes who have requirements of more than 200 units/day or 100 units/injection, use of U-500 regular insulin provided the same or better glucose control compared with U-100 insulin, with fewer daily injections and reduced injection volume. Although this drug represents an excellent treatment option, its safe use requires an experienced physician, a motivated and cooperative patient, and a dynamic diabetes management team.

Preliminary data suggested different patterns of hormonal control of linear growth in males and females. To better define these patterns, serum samples were collected from 75-125 boys and a similar number from girls for each year of age between 3-16 yr (n = 2416). Fewer samples were collected from 2-yr-olds, newborns, and adults (n = 151). Samples for each age were aliquoted, combined, and assayed for GH, GH-binding protein (GHBP), insulin-like growth factor-I, and testosterone. GHBP, expressed as a percentage of the [125I]GH bound, increased yearly in males and females, with no relationship to the secretion of sex hormones. The increase in binding of [125I]GH and, by inference, GH receptors occurred at a greater rate between the ages of 2-10 yr than between 10-16 yr (in terms of absolute binding, 1.2 +/- 0.11% vs. 0.38 +/- 0.04% yearly; P less than 0.001). In each age group, however, the increase in GHBP exhibited a strong positive correlation with linear height (r = 0.96-0.98 in males; r = 0.92-0.99 in females). Before puberty, GH and insulin-like growth factor-I concentrations were consistently greater in females. Between 10-16 yr of age, height velocity (centimeters of growth per yr) correlated strongly with GH in girls (r = 0.86), but did not correlate with GH in boys of a similar age (r = -0.13). The major pubertal growth spurt in males strongly correlated with a rise in serum testosterone concentration beginning at age 11 yr (r = 0.92). Small peaks of GH secretion before and after the major period of accelerated growth in males possibly prolonged the major growth phase, but did not initiate it.

Over the past three decades, the incidence and prevalence of neuroendocrine tumors have gradually increased. Due to the slow-growing nature of these tumors, most cases are diagnosed at advanced stages. Prognosis and survival are associated with location of primary lesion, biochemical functional status, differentiation, initial staging, and response to therapy. Octreotide, the first synthetic somatostatin analog, was initially used for the management of gastrointestinal symptoms associated with functional carcinoid tumors. Its commercial development over time led to long-acting repeatable octreotide acetate, a long-acting version that provided greater administration convenience. Recent research demonstrates that octreotide’s efficacy has evolved beyond symptomatic management to targeted therapy with antitumoral effects. This review examines the history and development of octreotide, provides a synopsis on the classification, grading, and staging of neuroendocrine tumors, and reviews the evidence of long-acting repeatable octreotide acetate as monotherapy and in combination with other treatment modalities in the management of non-pituitary neuroendocrine tumors with special attention to recent high-quality Phase III trials.

The binding of GH by a low affinity binding protein (LA-BP) was measured from birth into adulthood and compared with binding of a high affinity binding protein (HA-BP) in human serum. Pooled serum samples for each year of age from birth to 16.5 yr were formed from 2500 separate samples and assayed for both binding proteins using a Sephadex chromatographic method. Individual samples in this age range and those from adults were assayed in a similar manner. Binding of [125I]GH was minimal by both binding proteins in cord blood (binding by LA-BP, 2.77 +/- 0.32%; binding by HA-BP, 2.58 +/- 0.35% mean +/- SEM). A 4-fold increase to maximal binding for LA-BP occurred by the age of 5 yr and remained relatively constant through adolescence, except for a transient decrease at puberty. From 16.5-20 yr of age, binding by LA-BP decreased to a level no greater than that seen at birth. Binding by the HA-BP, which increased 6- to 8-fold reached maximal binding between 23-25 yr of age. Binding by HA-BP did not decrease in adults between the ages of 20-30 yr. Whereas pregnancy increased LA-BP activity, GH binding by HA-BP was unaltered.